Research update: CrossCurrents Autumn 2003

CrossCurrents

Mark de la Hey

Gender and ethnicity can inhibit disclosure

Mothers may be reluctant to disclose sensitive psychological and social information during initial visits to a pediatrician who is male or of a different ethnic background than the client, according to a study from Johns Hopkins University in Baltimore, Maryland. The study assessed the interaction between several hundred mothers and their physicians (who were all white) over a one-year period. The researchers rated each session for the number of psychosocial topics (family relationships, lifestyle, feelings, children's behaviour and development) discussed.

African-American mothers made 26 per cent fewer psychosocial statements than white mothers during early visits, but gave more information during later visits when paired with female physicians (but not with male physicians). White mothers initially made twice as many psychosocial statements to female physicians. The amount of information they gave male physicians increased during later visits, although they still gave more information to female physicians. The researchers found that mothers generally gave more information to physicians who adopted a client-centered style, characterized by "interpersonal sensitivity, partnership and medical information giving." The researchers suggest that barriers resulting from ethnic and gender differences can be lessened when physicians adopt a client-centered approach within a long-term client-physician relationship.

Archives of Pediatrics and Adolescent Medicine, May 2003, v. 157: 419-424. Lawrence. S. Wissow et al, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland.

Distress speeds onset of AIDS in injection drug users

Psychological distress is associated with a more rapid onset of AIDS in HIV-positive injection drug users (IDUs), according to researchers at Johns Hopkins University in Baltimore, Maryland. The study followed 451 HIV-positive (but AIDS-free) IDUs from 1988 through 1999, 106 of whom were distressed at the beginning of the study. Of these, 32 developed AIDS within two years. Clients considered to be distressed at the study's outset were more than twice as likely to develop AIDS within two years, even when adjusting for CD4 lymphocyte count, HIV viral load and oral thrush. Distress was almost five times as likely to be associated with rapid onset among those with low CD4 counts. However, distress did not independently predict death within two years, while CD4 counts and HIV viral loads did. Stress can increase cortisol levels in the body, thus inhibiting the ability of natural killer cells to fight infection. The authors note that although the study was limited by the small number of AIDS cases, it does suggest that efforts to manage psychological distress among clients with HIV may be beneficial.

Journal of Acquired Immune Deficiency Syndromes, April, 2003, v. 32(4): 429-434. Elizabeth T. Golub et al, Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland.

Violent lyrics increase aggressive thoughts and feelings

New research indicates that violent lyrics in songs increase aggressive thoughts and hostile feelings, and may subsequently contribute to aggressive behaviour. A series of five experiments were conducted at Iowa State University and the Texas Department of Human Services. More than 500 college students listened to either violent or non-violent songs and were then asked to perform various tasks designed to measure aggressive thoughts and feelings. Exposure to songs with violent lyrics led students to give more aggressive interpretations to words like "rock" and "stick," which have both aggressive and non-aggressive meanings. Students exposed to violent lyrics also read aggressive words more rapidly than non-aggressive words. The researchers note that their findings contradict the idea that listening to violent music has a cathartic effect, which lessens aggressive impulses. Rather, exposure to violent lyrics appears to prime aggressive impulses, and repeated exposure may contribute to the development of an aggressive personality in the long term.

Journal of Personality and Social Psychology, May 2003, v. 84(5): 960-971. Craig A. Anderson et al, Department of Psychology, Iowa State University, Ames, Iowa.

Psychiatric disorders worsen outcomes for men with substance use issues

Psychiatric disorders worsen the prognosis for drug dependence among men, but not among women, according to a study from Washington University in St. Louis, Missouri. Scientists recruited 401 individuals being treated at drug treatment facilities in St. Louis. At the beginning of the one-year study, all participants were free of intoxication and had been in treatment for at least two weeks. Seventy-four per cent had at least one psychiatric disorder. Substance use status was assessed at the end of the year. Men with psychiatric disorders in general, and particularly men with major depression or antisocial personality disorder, had worse outcomes after one year of treatment. Surprisingly, the presence of psychiatric disorders did not worsen the outcomes for women with substance use issues. Women with phobias actually had better outcomes, leading the researchers to speculate that their personalities may predispose them toward harm avoidance. The researchers conclude that outcomes for men undergoing treatment for substance use problems may be improved with simultaneous treatment of the co-occurring psychiatric disorder.

American Journal of Psychiatry, May 2003, v. 160(5): 890-895. Wilson M. Compton III et al, Division of Epidemiology, Services, and Prevention Research, National Institute on Drug Abuse, Bethesda, Maryland.

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